RESUMO
BACKGROUND & AIMS: The therapeutic mechanisms of ribavirin for hepatitis C are unclear. Microarray analyses have shown that ribavirin increases induction of interferon-stimulated genes. We evaluated viral kinetics, serum cytokine expression, and viral mutagenesis during early stages of peginterferon therapy with and without ribavirin. METHODS: Fifty patients with chronic hepatitis C virus (HCV) infection genotype 1 were randomly assigned to groups that were given peginterferon alpha-2a, with or without ribavirin, for 4 weeks; all patients then received an additional 44 weeks of combination therapy. First- and second-phase viral kinetics were evaluated. Serum levels of interferon-gamma-inducible protein-10 (IP10), monokine induced by interferon-gamma, and monocyte chemoattractant protein 1 were quantified as measures of the interferon-stimulated genes response. NS5A and NS5B were partially sequenced, and mutation rates were calculated. RESULTS: The first-phase decrease in HCV RNA was similar between groups. Patients who received ribavirin had a more rapid second-phase decrease, compared with patients who did not receive ribavirin-particularly those with an adequate first-phase decrease (0.61 vs 0.35 log10 IU/mL/week; P = .018). At 12 hours, fold induction of serum IP10 was higher in patients given the combination therapy than those given peginterferon only (7.6- vs 3.8-fold; P = .01); however, the difference was greatest in patients with an adequate first-phase decrease in HCV RNA. IP10-induction correlated with first- and second-phase kinetics and with ribavirin serum concentrations on day 3. HCV mutation rates were similar between groups. CONCLUSIONS: Ribavirin improves the kinetics of the early response to therapy in patients with an adequate initial response to peginterferon. Induction of interferon-stimulated cytokines correlates with viral kinetics following ribavirin therapy, suggesting that ribavirin promotes interferon signaling.
Assuntos
Antivirais/farmacologia , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Polietilenoglicóis/uso terapêutico , Ribavirina/farmacologia , Transdução de Sinais/efeitos dos fármacos , Adulto , Idoso , Quimiocina CXCL10/sangue , Feminino , Hepatite C Crônica/virologia , Humanos , Interferon alfa-2 , Interferon-alfa/administração & dosagem , Masculino , Pessoa de Meia-Idade , Mutação , Polietilenoglicóis/administração & dosagem , RNA Viral/sangue , Proteínas Recombinantes , Ribavirina/sangue , Resultado do TratamentoRESUMO
This work introduces a new high-throughput screening particle - a Dallas Amphorous Material No. 1 (DAM-1) molecular sieve particle. In contrast to porous silica microspheres, the 2-8-microm sized DAM-1 molecular sieve particles are available in a variety of shapes and morphologies including spheres, hexagons, rods, gyroids, and discoids. The advantage of using DAM-1 molecular sieve particles is the ability to encode an array by particle shape, which in turn permits the repeated use of luminescent reporter dyes. In this technical note, we demonstrate optical decoding of fluorescein- and Texas Red-modified shaped molecular sieve particles using reflectance and fluorescence microscopies.